RESUMO
The digestive duplications are defined as tubular or cystic-like malformations, sitting on a segment of the gastro-intestinal tract from the oral cavity to the anus. The wall of the duplication is formed by a double muscular tunic lined interiorly by a digestive-type mucous membrane. These malformations are characterized by a very large pathogenic, clinic and path anatomic polymorphism. It can be revealed by benign signs or sometimes by serious ones when a complication occur [hemorrhage, perforation]. Despite the fact, that the diagnosis is suspected clinically and largely evoked on the radiologic exams, it requires path anatomic confirmation. The authors report three cases of girls aged respectively 2,6 and 12 years without previous medical history, which first showed diffuse abdominal pain and periodicals, the radiological assessment including ultrasound abdominal CT scan and barium strongly suspected duplication in all three cases; however, confirmation was made by pathologists in three cases. Surgical excision has healing in our three patients. Our retrospective work consists of a survey of three gastric duplication cases seen at our hospital between years 1988 and 2008. It insists on different clinical and radiological aspects; relate diagnostic difficulties and therapeutic choices. Finally our set is particular by the presence of islands of heterotopic pancreatic tissue in all cases
RESUMO
Teratomas comprise all benign or malignant gonadal and extra gonadal, made of fabrics whose appearance recalls the various stages of embryonic development until the adult stage in some cases. It is an encapsulated tumor that develops from the primitive lineage and its immediate vicinity. The authors report a case of retroperitoneal teratoma in an infant of 5 months with no significant family history. The diagnosis was made on palpation of an abdominal mass. On the radiological assessment has objectified the presence of calcification lateral right vertebral and an almost complete involution of the vena cava inferior in kidney, while biologically, the results turned out normal. Surgical exploration confirmed the imaging data and showed that the particularly large tumor, that it has altered the anatomy and anatomical relations to a considerable extent. It is obvious that although this tumor is benign, its removal was very difficult because of anatomical changes. The teratoma retroperitoneal teratoma represents 4% of the child, 50% of them occur before the age of one year. The clinical onset is often marked by the discovery of an abdominal mass, abdominal-pelvic or signs of compression. Imaging can both refine the anatomical relationship of the mass in the preoperative evaluation; she showed an interruption of the IVC after injection in our young patient. The search for tumor markers [alpha FP and beta HCG] is used when it is positive to say the malignancy of teratomas. The surgical treatment, is to perform a complete resection of the tumor, when the preoperative surgery offers hope for full and non decaying. It is indicated from the outset or after chemotherapy. The proximity of vascular axes of the retroperitoneum makes it difficult to resect the tumor. The prognosis is not only a function of the degree of tumor aggressiveness but also the impact of the tumor on adjacent organs and operational difficulties. This case allowed once more to realize the shortcomings of antenatal screening, and demonstrated that, despite the Benin of the tumor, anatomic changes in the region can be very important making surgical resection of such tumors very difficult